Saturday, August 27, 2005

Not an operetta, not by a long shot

When I read the first paragraph or two of this article (via Norm Geras), I thought perhaps it was from the Onion. The King of Swaziland, banning sex thoughout the realm? A ceremony of dancing girls, burning the tassels that signified their chastity?

It also brought to mind a certain comic operetta, "The Mikado," the Gilbert and Sullivan masterpiece featuring a mythical Japan in which flirting was a capital crime; and a musical comedy from my youth, "Once Upon a Mattress," a retelling of "The Princess and the Pea," set in a fairy tale kingdom where no one could marry until the crown prince was wed.

But as I read on, I discovered that it's not a joke. It's real, and it's no operetta, despite the following:

As [the girls] arrived at the Queen Mother's palace on Monday, before taking off their tassels, they sang in jest: "At last, we can now have sex."

But after the strangeness--as well as the musical comedy overtones--of the story recede, we are left with a horrific human tragedy, that of AIDS in Africa and what to do about it. And the truth is that no one really seems to have all that much more of a clue than the King of Swaziland, a country in which 40% of the population is HIV positive.

Think about that for a moment: 40% of the people HIV-positive, and the mechanism of spread is heterosexual sexual contact. This is a prescription for the death of a country, and a region, unless something happens soon. But what is that something?

I've read many articles on the subject of AIDS in Africa, and there's no shortage of earnest proposals to help the situation. But most of the people who work in the field express a deep despair about the nature and scope of the problem.

I don't pretend to be an expert on this, and I'm most definitely not knocking those who are. But at the moment the problem seems virtually insurmountable. The AIDS situation in sub-Saharan Africa is so complex and terrible because the disease intersects with myriad other problems that have long plagued the area--poverty, malnutrition, other diseases, political and institutional corruption on a widespread scale, and the breakdown of tribal societies--particularly ancient marriage customs--with the coming of urbanization.

Although it may be un-PC to admit it, part of the picture are sexual mores (some of them connected with the exploitation of women) that have helped the AIDS epidemic run rampant in sub-Saharan Africa, along with official denial of the enormous extent of the problem. The King of Swaziland may indeed be a hypocrite, and he may be utterly unrealistic about human nature, but at least he's not in denial of the magnitude of the AIDS epidemic in his country.

Here's an article that offers a good summary of the AIDS problem in sub-Saharan Africa. It contained the following list of the elements that need to be in place to effectively prevent the spread of AIDS there. See how likely you think it is that most of the items on this list could be instituted any time soon, especially the final entry:

Widespread knowledge about HIV/AIDS and HIV prevention measures, such as safe sex practices and the use of condoms

Adequate networks and personnel for HIV/AIDS testing, counseling, education and care

Adequate funding for HIV prevention/treatment

Massive campaigns to remove the stigma of HIV/AIDS

Stable networks for education and health care

Strong political and public health leadership to address HIV prevention efforts

Empowerment of women

Enforced prohibitions against rape

Strong infrastructure (roads, telecommunications)

Strong and stable economies and governments that are not engaged in war or civil unrest

The article goes on to state that cultural customs around sexuality impede the fight against AIDS. If you have the stomach for it (and I warn you, it requires a very strong one) you could also take a look at this Village Voice article, which offers a great many depressing details about these customs and how they further the spread of the disease.

The following is an example (from the Voice article) of how certain cultural practices that once made sense in pre-AIDS tribal cultures have become part of the problem, post-AIDS:

Like many cultures in East and southern Africa, the Luo practice what is variously translated as home guardianship or, more commonly, widow inheritance. When a husband dies, one of his brothers or cousins marries the widow. This tradition guaranteed that the children would remain in the late husband's clan—after all, they had paid a dowry for the woman—and it also ensured that the widow and her children were provided for. When the guardian takes the widow, sexual intercourse is believed to "cleanse" her of the devils of death. A woman who refuses to take a guardian brings down chira—ill fortune—on the entire clan. Of course, if her husband died of AIDS, she might very well pass on the virus to her guardian. Millicent Obaso, a Luo public-health worker with the Red Cross, says: "We have homes where all the males have died because of this widow inheritance."

There is little doubt that underlying social change on a vast scale is necessary--as well as economic and political change. But how to effect changes in sexual practices in the absence of these deeper changes? Most attempts to accomplish this by legislation would be as doomed to failure as King Mswati's, even if they were more sophisticated than his.


At 6:02 PM, August 27, 2005, Blogger chuck said...

A friend of mine taught school in Swaziland back in the mid eighties. I recall that one of her students wrote a "what I did during vacation" essay about spending time as the mistress of a businessman. I also seem to recall that there were a lot of bar/brothel combos serving the border with South Africa. So I tend to agree that a lot of the AIDS problem is related to sexual mores and the breakdown of traditions. Indeed, I would claim that the Aids epidemic is almost entirely due to sexual mores and behavior and that morality has a place in changing that behaviour. In such situations it is better that healthy behaviour be judged as "good" and not as just a good idea.

Syphilis is another deadly sexual desease whose epidemic spread was pretty much dependent on sexual behaviour. Penicillin and mandatory testing did much to eliminate syphilis from everyday life back in the 40's and 50's, something that morality and lifestyle changes alone couldn't achieve. But I am unconvinced that morality played no role in limiting its effects before WWII and the advent of penicillin.

Speaking of public health, I recall being tested for tuberculosis before I could get a drivers license. The requirements of public health used to be far more intrusive, something we have forgotten or regard as some sort of archaic barbarism. After 9/11 and at the height of the anthrax scare I spoke with a friend of mine in the Bronx; she was appalled when I mentioned that controlling smallpox might require quarantine. We seem to have become infected with the idea that public health is a freebee and only our due.

At 6:53 PM, August 27, 2005, Blogger chuck said...


I have often speculated that the sexual license that came with the sixties was part of the breakdown of traditional families and social habits in this country. The two often seem to go together, not just in Africa. As part of the argument I usually posit that traditional society serves to make men bear some responsibility for their wives and children, something that seems to disappear when there are no sexual limits. As the Village Voice article points out, irresponsible male behaviour is a good part of the problem.

At 6:54 PM, August 27, 2005, Anonymous Anonymous said...

This is something I found on David Horowitz's blog:

Is the MSM deceiving us about the AIDS crisis in Africa? Well, it would not be the first time.

At 7:42 PM, August 27, 2005, Blogger Tom Grey said...

I can only barely believe you don't mention A B C.
Abstinence from sex until marriage.
Being faithful to your spouse.
Condoms for all others, all the time.
(From Uganda; despite the corruption)

I expect to go to Kenya in October working with a Slovak Medical University and Catholic Parish providing health clinic support.

How many have to die before behavior changes, making promiscuity taboo (again)?

At 10:38 PM, August 27, 2005, Blogger Rick Ballard said...


Here is an excellent report on the ABC effort in Uganda.

The problem is relatively self limiting in Africa. Treatment for HIV is so scarce that death comes relatively quickly. Part of the reason for the decline in incidence that is occuring is due simply to that factor.

At 12:53 AM, August 28, 2005, Anonymous Anonymous said...

Of course, banning sex is worthless and almost totally unenforcable (about the only way to know is by catching them in the act or pregnancy).

Not only is unenforcable, but when 40%(!!!) of your population with an incurable terminal illness transmitted by sexual activity doesn't stop you - nothing will.

I found the comments on the article interesting, things about abstinance being unrealistic. In cases such as here abstitance is going to happen one way or the other (well, unless we cure or find a vaccine for AIDS). Either they will contain it by abstinance or they will all die. Condoms aren't going to work, medication (the so called coctails) aren't going to work, nothing is. That number is simply too high for those methods of containment, hell they do not work too well for our .003% of the population (estimates are around one million with HIV, population of the US is around 297 million).

Not to mention that if seeing people die from AIDS isn't enough to scare you into, well, not having sex until you are married and only with individuals you absolutely trust, then nothing else is going to work (with 40% infected, they would have had to have seen at least one). Remember, things happen like mold grows on your tounge because your body can't fight it, colored growths on your body (again, mold), severe constant diaherra, you bleed out of any opening in your body or mucous membrane, lots and lots of terrible things.

*sigh* I guess these are probably the same people who think that terrorism can be solved by negotiation and talk and violence never solved anything.

At 10:23 AM, August 28, 2005, Blogger vanderleun said...

The harsh truth that most refuse to see is that there is a de facto form of triage going on in the civilized world. Concerts and studies and other efforts aside, the resources of the world are, at any given time, limited and probably do not extend to the task of saving all of Africa from AIDS. Bureaucracy, plutocracy, corruption, ignorance and mendacity on this scale is simply beyond the reach of rescue no matter how noble the intentions.

Perhaps it could be accomplished if the civilized world put aside every other rescue effort it is engaged in and concentrated resources, financial, political and military on Africa. But that is not at all likely to happen.

At 12:16 PM, August 28, 2005, Anonymous Anonymous said...

Sexual commitment to only one person or total abstinence are the only options. Does God hate promiscuity? Let’s leave this alone. Nature, though, seems to despise promiscuous behavior. The available empirical data are abundantly clear that engaging in unbridled passion will result in rampant diseases of one sort or another. What about condoms? They are not worthless, but an individual is playing Russian roulette when using them. There are just too many “accidents.” No, Africans---and numerous Americans---must learn to practice sexual restraint. You do not need to be a Pat Robertson nor Jerry Fallwell. A convinced atheist is also logically forced to reach the same conclusion.

At 9:54 AM, August 29, 2005, Anonymous Anonymous said...

I've always wondered why AIDS is such a "hip" and "cool" cause. Malaria kills 3 times as many and there are very effective ways to prevent and cure it. I hear nothing but crickets chirping when mentioned as number 4 on the list of “worlds deadliest killers”. So pardon my skepticism at the tears shed for AIDS victims. It has nothing to do with caring. I guess Bono or Elizabeth Taylor don't have friends with malaria.
10,700,000 children died in the world last year and 57% were from causes incident to malaria. That’s just the children.

At 5:06 AM, August 31, 2005, Blogger OBloodyHell said...

One must wonder, given the solutions pushed here, why AIDS isn't rampant in the porn industry to the point of having killed most of the non-mated sexual activities filmed (Not the actors, the practice). I'm sure there would always be filmed sex, but it would, if this were a problem, become more amateur married partners than regular performers...

Apparently, there *are* other solutions besides outright abstinence... LOL.


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